OPTIMISING HORMONE DOSAGE IN ASSISTED REPRODUCTION
Success with assisted reproductive technology (ART) depends upon production of multiple oocytes in response to daily injection of gonadotropin hormones. Hormonal dosing is a key challenge during Controlled Ovarian Stimulation (COS), and needs to be finely adjusted to avoid treatment cancellation due to low hormone response (low oocyte production), and also to avoid side effects and complications, including ovarian hyperstimulation syndrome (OHSS), which can lead to prolonged hospitalisation. An optimal range of response in term of oocytes collected is considered to be between 8-12.
OptimOvaTM is a patent-protected blood test developed at Oslo University Hospital. The test personalises hormone dosing by fine-tuning the routine dosing standard and adjusting the prescribed dose to the patient’s needs. The objective of this novel test is to optimise egg production, thus increasing the chances for having enough good quality embryos and ultimately improving chances for pregnancy and live birth delivery. In addition, excess good quality embryos are cryopreserved for future cycles, eliminating the need for further hormonal treatment. We have conducted a prospective randomised controlled single-centre clinical trial (ClinicalTrials.gov identifier: NCT 02915900) which included 111 IVF patients attending treatment at the Reproductive Medicine Department at Oslo University Hospital, and demonstrated OptimOvaTM validity by increasing the number of patients with an optimal treatment response.
The IVF-Fit team is looking for external collaborations for commercialisation of this product.
Contact: Ana Lobato-Pascual, email@example.com
Our project has been admitted to UiO´s innovation programme SPARK Norway 2018-2019:
Ovarian ageing and disease
Ovarian ageing is closely linked to the number of remaining follicles in the ovary and the genetic integrity of the oocytes enclosed in these follicles. Disorders and conditions that are related to increased or reduced number of ovarian follicles, like polycystic ovary syndrome (PCOS), ovarian endometriosis or unilateral oophorectomy, would be expected to slow or accelerate the rate of ovarian ageing. For example, polycystic ovaries are endowed with an increased number of follicles, and PCOS was suggested to prolong fertility of women treated with IVF. Endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity, typically on the peritoneum or ovaries, and by inducing reactive inflammation it may interfere with follicle development. Removal of a single ovarian because of disease or for fertility preservation may also alter the dynamics of follicle depletion and ovarian ageing. We aim to study how PCOS, endometriosis, and removal of an ovary affect reproductive ageing and the outcome of infertility treatment.
Assessment of ageing oocytes
Numerical chromosomal errors, which strictly correlate with maternal age, may affect as much as 60% of human oocytes. Most embryos derived from these oocytes are non-viable, and therefore assessment of oocyte normality could increase the efficiency of assisted reproduction treatment. Conventional light microscopy cannot, however, detect age-related deterioration of oocytes and embryos derived in vitro. To overcome these shortcomings, new methods are needed to assess oocyte and embryo competence. For example, time-lapse imaging of fertilized oocytes allows precise assessment of cell cycle kinetics that may be related to genetic integrity. Furthermore, polar body biopsy (PBB) is a non-destructive diagnostic procedure that takes advantage of the meiotic expulsion of a set of homologous chromosomes followed by a set of sister chromatids, in the form of first and second polar bodies, respectively. Polar bodies can be removed using standard micromanipulation techniques without harming the oocyte, and can be evaluated for aneuploidy in the laboratory. PBB avoids removal of material that would otherwise contribute to the embryo, thus reducing the chances of impairing embryonic development. We aim to develop additional methods to evaluate the developmental potential of embryos created in vitro.